Nicola Stefania, Badiu Iuliana, Rashidy Nicolò, Saracco Elena, Montabone Erika, Lo Sardo Luca, Boem Marzia, Marmora Valentina, Corradi Federica, Ricotti Andrea, Borrelli Richard, Rolla Giovanni, Negrini Simone, Brussino Luisa
Department of Medical Sciences, University of Turin, Immunology and Allergy Unit, Mauriziano Hospital, 10128, Turin, Italy.
Hospital Administration Unit, Mauriziano Hospital, 10128, Turin, Italy.
World Allergy Organ J. 2025 Jul 28;18(8):101095. doi: 10.1016/j.waojou.2025.101095. eCollection 2025 Aug.
The COVID-19 pandemic significantly increased the demand for allergy consultations to evaluate the risk of hypersensitivity reactions in patients either before receiving their first dose of an anti-SARS-CoV-2 vaccine (Group 1) or following suspected allergic reactions after vaccination (Group 2).
We conducted a retrospective analysis of patients referred to the Immunology and Allergy Unit of the Azienda Ospedaliera Ordine Mauriziano in Turin, Italy, between December 2020 and December 2022. Risk assessment was performed according to Italian and European guidelines, and allergy skin tests were administered when necessary. Patient data were cross-referenced with the SIRVA platform (Regional Vaccination Management Information System) to assess vaccine eligibility, administration, and outcomes.
A total of 1222 patients were evaluated (mean age: 52 years; female-to-male ratio 4:1). In Group 1 (n = 914), 137 patients (15%) underwent skin testing, of whom 15 (1.6%) tested positive. Vaccination was recommended for 899 patients (98%), though 184 (20%) did not proceed. Among those vaccinated, 679 (74%) received additional doses, with 48% receiving a third and 11% a fourth dose. In Group 2 (n = 308), 104 patients (33%) underwent skin testing, with 9 (8%) testing positive. Vaccination without restrictions was recommended for 299 patients (97%), but 45 patients (15%) did not proceed. Among the remaining, 262 (85%) received a second dose, 183 (59%) a third, and 29 (9%) a fourth dose. Overall, 1198 patients (98%) had no specific contraindications to vaccination. Only 5 patients (0.4%) were completely exempted from vaccination due to confirmed sensitivity to both polyethylene glycol (PEG) and polysorbate 80 (PS80). An alternative vaccine was recommended for 19 patients; 16 of them proceeded with vaccination and tolerated it without adverse effects.
Our findings demonstrate that the majority of high-risk allergic patients can safely receive anti-SARS-CoV-2 vaccines following allergological evaluation. The rate of confirmed excipient allergy was very low, and vaccine adherence was comparable to the general population. This is, to our knowledge, the first study to longitudinally assess the number and types of vaccine doses administered to high-risk allergic individuals.
2019冠状病毒病（COVID-19）大流行显著增加了过敏咨询的需求，以评估患者在接种第一剂抗SARS-CoV-2疫苗之前（第1组）或接种疫苗后出现疑似过敏反应之后（第2组）发生超敏反应的风险。
我们对2020年12月至2022年12月期间转诊至意大利都灵毛里齐亚诺医院免疫与过敏科的患者进行了回顾性分析。根据意大利和欧洲指南进行风险评估，并在必要时进行过敏皮肤试验。将患者数据与SIRVA平台（地区疫苗接种管理信息系统）进行交叉核对，以评估疫苗的适用性、接种情况和结果。
共评估了1222例患者（平均年龄：52岁；男女比例为4:1）。在第1组（n = 914）中，137例患者（15%）接受了皮肤试验，其中15例（1.6%）检测呈阳性。建议899例患者（98%）接种疫苗，不过184例（20%）未接种。在接种疫苗的患者中，679例（74%）接种了额外剂量，48%接种了第三剂，11%接种了第四剂。在第2组（n = 308）中，104例患者（33%）接受了皮肤试验，9例（8%）检测呈阳性。建议299例患者（97%）不受限制地接种疫苗，但45例患者（15%）未接种。在其余患者中，262例（85%）接种了第二剂，183例（59%）接种了第三剂，29例（9%）接种了第四剂。总体而言，1198例患者（98%）没有接种疫苗的特定禁忌证。只有5例患者（0.4%）因确认对聚乙二醇（PEG）和聚山梨酯80（PS80）均过敏而完全豁免接种疫苗。建议19例患者接种替代疫苗；其中16例接种了疫苗且耐受良好，未出现不良反应。
我们的研究结果表明，大多数高危过敏患者在经过变态反应学评估后可以安全接种抗SARS-CoV-2疫苗。辅料过敏确诊率非常低，疫苗接种依从性与普通人群相当。据我们所知，这是第一项纵向评估高危过敏个体接种疫苗剂量数量和类型的研究。
